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斜视手术患儿使用琥珀酰胆碱后下颌肌肉张力情况

Jaw muscle tension after succinylcholine in children undergoing strabismus surgery.

作者信息

Saddler J M, Bevan J C, Plumley M H, Polomeno R C, Donati F, Bevan D R

机构信息

Department of Anesthesia, Montreal Children's Hospital, Quebec.

出版信息

Can J Anaesth. 1990 Jan;37(1):21-5.

PMID:2295102
Abstract

The increases in tension at the masseter and adductor pollicis muscles following succinylcholine, 1 mg.kg-1, during halothane anaesthesia were measured in eight children, 3-10 yr, with strabismus. The results were compared with those obtained in a control group of general surgical patients. Supramaximal train-of-four (TOF) stimulation was applied to the ulnar nerve and the nerve to the masseter simultaneously. Jaw closure was measured by a force transducer system. In all patients, succinylcholine caused an increase in resting tone at the jaw and at the thumb. In the strabismus group, the magnitude of this increase was 55.7 +/- 23.2 g, mean +/- SD, at the jaw and 11.3 +/- 5.6 g at the thumb. This was not significantly different from the values obtained in controls, 45.3 +/- 33.4 g and 7.9 +/- 4.2 g, respectively. The duration of the phenomenon was 1-2 min in both muscles studied, and was not statistically different in the strabismus group. Time to complete neuromuscular blockade was significantly faster at the masseter, 31 +/- 6 sec--control groups; 39 +/- 11 sec--strabismus group, than at adductor pollicis, 61 +/- 34 sec--control groups; 75 +/- 28 sec--strabismus group (P less than 0.05 and 0.013 respectively). It is concluded that succinylcholine causes similar increases in jaw tension and comparable degrees of neuromuscular blockade in patients undergoing strabismus surgery as in other children.

摘要

在8名3至10岁患有斜视的儿童中,测量了在氟烷麻醉期间静脉注射1mg.kg-1琥珀酰胆碱后咬肌和拇内收肌的张力增加情况。将结果与一组普通外科手术患者的结果进行比较。同时对尺神经和咬肌神经施加超强四个成串刺激(TOF)。通过力传感器系统测量下颌闭合情况。在所有患者中,琥珀酰胆碱均导致下颌和拇指的静息张力增加。在斜视组中,下颌静息张力增加幅度为55.7±23.2g(均值±标准差),拇指为11.3±5.6g。这与对照组分别为45.3±33.4g和7.9±4.2g的值无显著差异。所研究的两块肌肉中该现象的持续时间均为1至2分钟,斜视组之间无统计学差异。咬肌完成神经肌肉阻滞的时间明显快于拇内收肌,对照组咬肌为31±6秒,斜视组为39±11秒;对照组拇内收肌为61±34秒,斜视组为75±28秒(P值分别小于0.05和0.013)。结论是,琥珀酰胆碱在斜视手术患者中引起的下颌张力增加和神经肌肉阻滞程度与其他儿童相似。

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